Robert E. McKeown, PhD, Arnold School of Public Health, Univ. of South Carolina, University of South Carolina, Columbia, SC 29208, 8037776220, rmckeown@gwm.sc.edu, Charity G. Moore, PhD, Department of Biostatistics and Epidemiology, University of South Carolina, School of Public Health, Columbia, SC 29208, and Steven P. Cuffe, MD, Department of Neuropsychiatry and Behavioral Sciences, University of South Carolina, School of Medicine, Columbia, SC 29208.

Estimates of rates of ADHD vary widely due in part to changes in diagnostic criteria and differing accounts of impairment. Though the Diagnostic and Statistical Manual (DSM) requires “clinically significant impairment” for a diagnosis, impairment is not defined. This presentation examines the impact of various definitions of impairment on national prevalence. Methods: Data from over 10,000 sample children between the ages of 4 and 17 with parent-completed Strengths and Difficulties Questionnaire (SDQ) in the 2001 NHIS. Results: 12.2% of boys and 5.6% of girls met symptom score criterion, but the prevalence dropped to 5.6% of boys and 2.3% of girls when the impact requirement was included. When impairment in at least two settings was used instead, the prevalence was 4.2% of boys and 1.8% of girls. Requiring distress in the child resulted in further reduction. Among those with SDQ ADHD, 35.3% of boys and 41.1% of girls had talked to a mental health professional in past 12 months, compared to 4.8% of boys and 4.7% of girls without SDQ ADHD. 49.6% of boys and 55.6% of girls with SDQ ADHD had talked to a health professional for emotional/behavioral problems, compared to 6.6% of boys and 6.2% of girls without SDQ ADHD. Conclusions: Including impairment in the case definition impacts prevalence of ADHD. Severity and extent of impairment required further influence prevalence estimates. In spite of the higher level of service use among children with significant symptoms and impairment, a high percentage of children impacted by ADHD remain without care.

Learning Objectives:

• 1) Describe the modes and severity of impairment among a nationally representative sample of US youth with and without ADHD.
• 2) Describe the impact that different definitions of impairment have on prevalence estimates.
• 3) Describe the rates of health service use by children with and without significant ADHD symptoms and impairment.

Keywords: Mental Health, Children and Adolescents

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.